Table 4.
Main results of systematic reviews focused on the link between shift work and hypertension.
| References, Country | Type - Shift work (n) | Assessment of outcomes (n) |
Confounding
factors (n) |
Main results shift work vs. day work (n) |
|---|---|---|---|---|
| Esquirol et al. (12), France | Permanent night (5) Rotating (33) Evening (2) |
HTN (13) BP measures (14) 24-h Ambulatory BP (5) HTN history (2) |
NA (15) Adjustments (19) |
Longitudinal studies: Shift work: HTN OR = 1.10 (1.01–1.20) (1); progression from mild to severe HTN OR = 1.23 (1.05–1.44) (1) Shift work: raised systolic or diastolic BP: significantly (3), no difference (7) Sub-group analyses: - Age and Shift work: 30–39 yo (NS); 40–49 yo OR = 1.62 (1.17–2.24); 50–59 yo (NS) (1) - Duration and shift work: ♂ ≥30 yo: SW duration positively associated with SBP (p < 0.05); ♀ <30 yo: SW duration inversely associated with DBP (p < 0.05) (1); SBP and DBP associated with duration of SW (p < 0.05); BP fell morning to afternoon to night (p = 0.03) (1) - Shift work after 1-year follow-up: NS change in BP (1) |
| Proper et al. (14), Netherlands | Permanent night (1) Rotating (13) Unspecified (5) |
HTN (11) BP mesures (7) Self-reported (3) Register (1) |
NA (2) Adjustments (15) Unspecified (2) |
Shift work: significant increased risk of HTN (9); NS (6) Permanent night: HTN OR = 0.9 (0.6–1.2) (1) Shift work: significant elevated risk of increased BP (1); NS (6) |
| Manohar et al. (31), USA Meta-analysis |
Rotating (18) Permanent night (4) Irregular (2) Unspecified (4) |
HTN (18) Self-reported BP (7) BP measures (1) MD (1) |
NA (2) Adjustments (25) |
Shift work: cohort studies: HTN pooled OR = 1.31 (1.07–1.60), I2 90%; cross-sectional studies: HTN pooled OR = 1.10 (1.00–1.20), I2 85% Rotating: cohort studies: HTN pooled OR = 1.34 (1.08–1.67), I2 91% Permanent night: cross sectional studies: HTN pooled OR = 1.07 (0.85–1.35), I2 83% Sub-group analyses: Rotating: cohort studies HTN ♂ pooled OR = 1.21 (1.04–1.40), I2 63%; HTN ♀ pooled OR = 1.01 (0.70–1.44), I2 14% Permanent night: cross-sectional studies ♀ pooled OR = 1.07 (0.88–1.30), I2 66% |
| Gamboa Madeira et al. (31), Portugal Meta-analysis |
Permanent night (14) Rotating with night (30) without night (4) Unspecified (8) |
HTN (14) BP measures (41) |
NA (32) Adjustements (13) |
Rotating with night: HTN pooled OR = 1.26 (0.94–1.68), I2 90% (8) Rotating without night: HTN OR = 1.00 (0.88–1.15) (1) Permanent night: HTN pooled OR = 1.00 (0.80–1.27), I2 35% (6) Permanent night: increase mean difference SBP = 2.52 mmHg (0.75–4.29), I2 91% (12); DBP = 1.76 mmHg (0.41–3.12), I2 93% (12) Rotating with night: increase mean difference SBP = 0.65 mmHg (0.07–1.22), I2 69% (28); DBP = 0.12 mmHg (−0.31 to 0.54), I2 65% (25) Rotating without night: increase mean difference SBP = 1.28 mmHg (0.18–2.39), I2 93% (4); DBP = 0.60 mHg (−0.24 to 1.43), I2 92% (4) |
(n), number of studies concerned; HTN, Hypertension; SBP and DBP, Systolic and Diastolic Blood Pressure; MD, Missing Data; NA, Non adjusted; NS, Non significant.